Abstract Cerebral venous thrombosis (CVT) causes significant disability and mortality. All published studies from MEDLINE and EMBASE up to February 2019 containing patients diagnosed with cerebral venous thrombosis who were treated with a direct oral anticoagulant (dabigatran, rivaroxaban, apixaban, or edoxaban) will be included. [Medline]. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Stroke. [Medline]. 2010 Apr. Direct thrombolysis for cerebral venous sinus thrombosis. The current guidelines state that DOAC use is not indicated in CVT because no high-level studies have been done as of yet; however, multiple case reports and case series have been published in the literature which have not been systematically reviewed, as well as possibly small trials. A risk of bias analysis will be performed to evaluate quality of studies overall. Cerebral venous thrombosis (CVT) is an important cause of stroke in young adults (mean age 33 years with a two-thirds female preponderance) 1 caused by complete or partial occlusion of the cerebral major cerebral venous sinuses (cerebral venous sinus thrombosis) or the smaller feeding cortical veins (cortical vein thrombosis). and Prevention. [Medline]. This systematic review will investigate the experience DOAC use in CVT, with assessment of reported safety and efficacy. The design of this systematic review follows the PRISMA-P [8] and PRISMA [9] guidelines where applicable. Article Please confirm that you would like to log out of Medscape. Left lateral sinus thrombosis demonstrated on magnetic resonance venography (MRV). J Neuroimaging. We report a unique series of young patients with COVID-19 presenting with cerebral venous system thrombosis. During pregnancy and puerperium, the higher risk of CVT occurs in the first … In stage one, two authors (GB, JG) screen abstracts and titles for potentially relevant articles, and in stage two, two authors (GB, JG) read potentially relevant articles to confirm that they met the inclusion criteria. 61(8):1057-60. ClinicalTrials.gov Identifier: NCT03191305. Rev Neurol (Paris). Available from: http://www.ncbi.nlm.nih.gov/pubmed/27733354. statement and Schievink WI, Maya MM. Magnetic resonance imaging in lateral sinus hypoplasia and thrombosis. Int J Stroke. 338385-overview 1973 May-Jun. Bose G, Graveline J, Dowlatshahi D. Systematic review of direct oral anticoagulants in treatment of cerebral venous thrombosis. However, due to the rarity of CVT, trials comparing DOAC to heparin or VKA have been minimal, as such, the published guidelines recommend not using DOAC in treatment of CVT despite the potential advantages. [Medline]. [Medline] . 338(8767):597-600. Jacobs K, Moulin T, Bogousslavsky J, et al. Google Scholar. Lancet. 1998 Mar. [Medline]. J Neurosurg Sci. 2009 Nov. 27(5):E7. If the thrombus breaks off (it embolizes) and flows towards the lungs, it can become a pulmonary embolism (PE), a blood clot in the lungs. A recently reported guideline has been published by the European Stroke Organization in 2017, strongly recommended acute treatment with therapeutic heparin based on two randomized trials, however stated that there is still insufficient evidence to use DOAC in CVT based on two published case series and not by systematic review [5]. Cochrane Database Syst Rev. 2000 Jul. Cerebral venous thrombosis: a practical guide Leonardo Ulivi,1 Martina Squitieri,1 Hannah Cohen,2,3 Peter Cowley,1,4 David J Werring1,4 ABSTRACT All neurologists need to be able to recognise and treat cerebral venous thrombosis (CVT). Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Urokinase, Altevase, Streptokinase, Heparin, Warfarin. Ingelheim B. 1997 Jun. Stroke . https://doi.org/10.1186/s13643-019-1022-8, DOI: https://doi.org/10.1186/s13643-019-1022-8. Stroke. Available from: http://stroke.ahajournals.org/cgi/doi/10.1161/01.STR.0000117571.76197.26. [Medline]. The differences in incidence in the studies are 2003 May. A search strategy was developed with a research librarian. Cerebral vein thrombosis (CVT) is a medical emergency requiring rapid treatment to prevent venous infarct, hemorrhage, and eventual neurologic disability or mortality. Oppenheim C, Domigo V, Gauvrit JY, et al. Neurosurgery. Eur J Neurol. The two studies were seven patients treated with rivaroxaban, published in 2014 [13], and 15 patients treated with dabigatran published in 2015 [14]. 1992 Feb. 10(1):87-111. . South Med J. The syndrome of latent cerebral venous thrombosis: its frequency and relation to age and congestive heart failure. Two authors (GB, JG) will independently extract data capturing pertinent demographics, treatment dosage and duration, and follow-up and outcomes. There is a trend in declining frequency of CVT patients presenting with focal deficits or coma and a decrease in mortality over time. Ferro JM, Crassard I, Coutinho JM, Canhão P, Barinagarrementeria F, Cucchiara B. Decompressive surgery in cerebrovenous thrombosis: a multicenter registry and a systematic review of individual patient data. Stroke. Ennaifer R, Moussa A, Mouelhi L, et al. It aims to support rapid diagnosis and effective treatment for people who develop deep vein thrombosis (DVT) or pulmonary embolism (PE). The protocol is hosted on the registered database, PROSPERO (CRD42017078398) [10]. Helmi L Lutsep, MD is a member of the following medical societies: American Academy of Neurology, American Stroke AssociationDisclosure: Medscape Neurology Editorial Advisory Board for: Stroke Adjudication Committee, CREST2; Physician Advisory Board for Coherex Medical; National Leader and Steering Committee Clinical Trial, Bristol Myers Squibb. In 2017, the European Stroke Organization updated the previous guidelines from the European Federation of Neurological Societies. [Medline]. Andrew P Keegan, MD is a member of the following medical societies: American Academy of Neurology, American Medical AssociationDisclosure: Nothing to disclose. Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of cerebral venous sinus thrombosis Yuhua Fan , 1 Jian Yu,1 Hongbing Chen,1 Jian Zhang,1 Jiangang Duan,2 Dapeng Mo,3 Wenhao Zhu,4 Bo Wang,3 Fubing Ouyang,1 Yicong Chen,1 2004;35(3):664–70. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Current guidelines recommend anticoagulation after cerebral venous sinus thrombosis (CVT) even in the setting of intracranial hemorrhage, but the timing of initiation is unclear. Gustafsson D, Elg M. The pharmacodynamics and pharmacokinetics of the oral direct thrombin inhibitor ximelagatran and its active metabolite melagatran: a mini-review. 2009;339:b2700. Medscape Education. Available from: http://doi.wiley.com/10.1111/ene.13381. The secondary outcomes are efficacy data including recanalization time and rates, the initial and final modified Rankin Scale, and the initial and final National Institute of Health Stroke Scale score. Medel R, Monteith SJ, Crowley RW, Dumont AS. 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